Services
24/7 PA Services
We provide around-the-clock services for status determination, offering constant feedback to Hospital Utilization Management (UM) teams. Ensuring patients are in the correct status prior to discharge is crucial for improving hospital throughput. Incorrect status assignments for discharged patients can have a significant financial impact. We offer effective AI-guided services, coupled with physician/UR Nurse partnerships, to ensure accurate status determination upon admission and discharge.
Denial Management
Managing medical claims denials has become a major operational challenge for healthcare institutions. With Medicare Advantage enrollment consistently increasing, payers have become more aggressive in denying cases. A robust denial management system is essential to combat these challenges. We offer effective defense through our robust denials management team.
Provider Education
Provider education and feedback are essential for the success of a good UM program. We integrate CMS regulations and key medical necessity information to support physician decision-making. Additionally, we provide key performance indicators and national statistics to drive physician change management.
24/7 Physician Advisor Support
Our team of licensed, board-certified physician advisors provides expert support to UM teams around the clock, both full-time and remotely. They help improve throughput, reduce observation Length of Stay (LOS) and denials, optimize reimbursement, and shorten revenue cycles. Our physicians are proficient in InterQual and MCG, benchmarks used by major payers, ensuring appropriate status oversight from admission.
Our services are available year-round, including holidays, with a turnaround time of no longer than 2 hours. Hospitals must capture appropriate reimbursement and prevent denials, even during off-hours. Our gap support services cover these hours, accommodating any physician advisor needs.
UM (Utilization Management) Services
Utilization review enhances the quality of care, accelerates patient recovery, and reduces unnecessary medical treatment. Our mission at Bottle Health is to leverage nationally recognized guidelines to ensure compliance and provide timely recommendations to our clients regarding the appropriateness of care. All our UR services are conducted in strict accordance with state-mandated guidelines and URAC-approved protocols, delivered by our in-house team of licensed and registered nurses under the clinical direction of our medical directors.
